Zimbabwe a regional health risk

Richard Tren | 11 Mar 2005
Business Day (South Africa)
Zimbabwe is gearing up for another election, which by all reckoning will be neither free nor fair. Outrageous abuses of human rights committed by the Mugabe regime in order to cling on to power have been well-documented in the free and independent media. Less well-reported is the effect on the country's health-care system of the political and economic turmoil, which is now so dire that it threatens the entire region. The fact that citizens of Zimbabwe's neighbours are at risk of disease from Zimbabwe also highlights, as if it were necessary, the failure of President Thabo Mbeki's policy of "quiet diplomacy". Zimbabwe had an admirable health-care system that improved the lives of almost all its citizens.

Soon after President Robert Mugabe was elected into power in 1980, his government increased spending on health care by 80%, spending almost three times more on health than other sub-Saharan African countries. It had one of the highest rates of immunisation in Africa. Life expectancy rose almost 10 years between 1980 and 1987. As explained in a report released today, Despotism and Disease, its once outstanding health-care system has been destroyed. Life expectancy is 33 years, almost 23 years lower than it was in 1985.

Lives that ordinary Zimbabweans now lead are not only shorter, but more brutish and nasty. The incidence of infectious disease has risen alarmingly in recent years. The Zimbabwean government's response to the horrific incidence of HIV/AIDS has been woefully inadequate and, far from improving treatment, its National AIDS Council is proving to be a bureaucratic barrier to access and a tool of the ruling party.

Zimbabwe once had an outstanding malaria-control programme, but in recent years any semblance of control has disappeared. Spraying tiny amounts of insecticides inside houses ensured, such as in SA, that malaria was a minor health problem in Zimbabwe for decades. Yet starved of cash, the malaria control teams covered only 3,4% of houses that should have been sprayed. Consequently, this preventable and curable disease has been increasing alarmingly in many areas. The leadership shamelessly politicises health care.

At a malaria education rally held near Lake Kariba late last year, Health Minister David Parirenyatwa began his lengthy speech by chanting: "Down with the MDC (Movement for Democratic Change), down with mosquitoes." Qualified personnel in clinics and hospitals are becoming rarer as doctors and nurses flee the country for better pay and working conditions elsewhere. There are now no gynaecologists, no orthopaedic surgeons and only three general surgeons serving all of Bulawayo. The economic crisis means the government has less money to spend on health care. M

ilitary spending has been maintained and now exceeds the health-care budget. The hated Central Intelligence Organisation managed to secure a six-fold increase in its budget last year. The lives of Zimbabweans are in peril because of inadequate nutrition. For the first time in decades, children with kwashiorkor are streaming into clinics and hospitals. With a 70%-80% unemployment rate and the agricultural sector all but destroyed, Zimbabweans do not get enough food to survive. The government has used it as a political weapon, denying food to people who cannot prove they are ruling party members.

But while the increase in death and disease is a tragedy, it is not purely a domestic issue. Anywhere between 3-million and 5-million Zimbabweans live outside the country for either economic or political reasons. Due to the collusion of most Southern African Development Community governments with the Mugabe regime, refugees and exiles are never given protection and recognition. Living on the margins of society, many have little access to decent health care in their host country. With few prospects and little hope, it is understandable that many will discount the threat of HIV and engage in risky sexual behaviour that could well worsen the incidence of HIV/AIDS in Zimbabwe's neighbouring countries.

Zimbabwe has been classified as an "outpost of tyranny" by the US government and now, it seems, the tyranny is being spread in the region in the form of viruses, parasites and bacteria by the unfortunate Zimbabweans that Mugabe has driven out of their own homes. Without clear and unequivocal condemnation of the abuses of the Mugabe regime, and meaningful efforts to support peace and democracy by SA and Zimbabwe's other neighbours, the situation can only deteriorate in the run- up to the election and thereafter. Anything less would cheat and threaten the entire region.
 
Tren is director of health advocacy group Africa Fighting Malaria.